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2025 PHPM Royal College Study - based on AN Summary Notes > CD - HPV, Lyme, West Nile, Zika > Flashcards

CD - HPV, Lyme, West Nile, Zika Flashcards

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1
Q

what is the agent for HPV infection and how many types are there (1)

A

1- over 200 distinct types of human papillomaviruses have been identified

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2
Q

what is the reservoir for HPV (1)

A

1- humans

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3
Q

what are risk factors for acquiring HPV -
‘sexual behaviours’ - 5
‘substance use’ - 1
‘immunosuppression’ - 2

(8)

A

1- lifetime number of sexual partners
2- history of previous STIs
3- history of sexual abuse
4- MSM (for men)
5- inconsistent condom use
6- tobacco or marijuana use
7- immunosuppression
8- HIV infection

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4
Q

what is the mode of transmission for HPV (2)

A

1- vertical
2- contact (direct epithelial to epithelial contact)

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5
Q

what is the incubation period for HPV - range (1)

A

1- range = 1-20 months

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6
Q

what is the communicable period for HPV - general (1)

A

1- Presumably communicable during the acute infection and during persistent infection

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7
Q

what percentage of Canadians, if unimmunized against HPV, will have an HPV infection at some point? (1)

A

1- 75% of Canadians unimmunized against HPV will have an HPV infection at some point

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8
Q

what is the typical clinical presentation of HPV (1)

A

1- most HPV infections are asymptomatic

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9
Q

do you need to treat HPV infections (1)

A

1- no - most HPV infections are self-limiting

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10
Q

how long does it generally take for HPV infections to resolve without treatment (1)

A

1- HPV infections generally resolve within 24 months without treatment

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11
Q

what are the high-risk HPV types (7)

A

16, 18, 31, 33, 45, 52, 58

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12
Q

what disease can the high-risk HPV types lead to (1)

A

1- cancer

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13
Q

what kinds of cancer can the high-risk HPV types lead to -

go from bottom to the top of body

(8)

A

1- vulva
2- vagina
3- cervical
4- penis
5- anogenital
6- anus
7- oropharynx
8- mouth

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14
Q

what are the low-risk HPV types (2)

A

6, 11

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15
Q

what kind of disease do the low-risk HPV types cause (1)

A

1- genital warts

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16
Q

which HPV vaccines are authorized for use in Canada (2)

A

1- gardasil-9 (HPV9)
2- cervarix (HPV2)

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17
Q

which HPV types does gardasil-9 protect against (1)

A

1- gardasil-9 protects against the 9 types of HPV mentioned - 6, 11, 16, 18, 31, 33, 45, 52, 58 - i.e. both low and high-risk

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18
Q

which HPV types does cervarix protect against (1)

A

1- HPV 16 and 18

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19
Q

how effective are current HPV vaccines at preventing cervical cancer and its precursors? (1)

A

1- VERY - efficacy of HPV9 vaccine against types 16- and 18-related cervical disease is nearly 100%

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20
Q

how effective are current HPV vaccines at preventing genital warts (1)

A

1- VERY - efficacy against external genital lesions related to HPV types 6, 11, 16, or 18, including genital warts, is 95% to 99%

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21
Q

how effective are current HPV vaccines at preventing high-grade disease

A

1- VERY - efficacy against high grade disease related to HPV types 31, 33, 45, 52, and 58 contained in HPV9 vaccine is over 96%

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22
Q

what is the recommended dosing of HPV9 for immunocompetent individuals age 9-20 (1)

A

1- one-dose schedule

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23
Q

what is the recommended dosing of HPV9 for immunocompetent individuals age 21-26, and 27+ (1)

A

1- two-dose schedule

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24
Q

what is the recommended dosing of HPV9 for Individuals who are immunocompromised and/or living with HIV, regardless of age (1)

A

1- three-dose schedule

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25
Q

what are the indications for getting HPV vaccine in girls and women (6)

A

Prevention of :
1- vulvar ca
2- vaginal ca
3- anal ca
4- oropharyngeal and other head and neck cancers
5- genital warts
6- precancerous lesions

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26
Q

what are the indications for getting HPV vaccine in boys and men (4)

A

1- anal ca
2- oropharyngeal and other head and neck cancers
3- genital warts
4- precancerous lesion (anal intraepithelial neoplasia)

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27
Q

In July 2020, the Federal Drug Administration in
the USA approved indication of HPV vaccine for
prevention of head and neck cancer - why is this a hot topic? (1)

A

1- because prior to this, HPV vaccine was only approved for use in the prevention of anogenital-related cancers

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28
Q

what are some reasons for seeing increasing trends in STIs - host factors (4)

A

1- increased number of sexual partners
2- unprotected intercourse
3- substance use
4- increased awareness of (and getting) testing

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29
Q

what are some reasons for seeing increasing trends in STIs - agent factors (2)

A

1- antimicrobial resistance
2- synergistic interactions between microbes

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30
Q

what are some reasons for seeing increasing trends in STIs - environment factors (4)

A

1- changes in case definitions and/or clinical guidelines
2- new medical treatments (e.g. PrEP)
3- social media and dating apps
4- changes to tests (e.g. increased sensitivity)

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31
Q

what is the Pan Canadian STBBI Framework for Action (1abcde)

A

1a- the framework sets out a
1b- vision,
1c- desired outcome,
1d- strategic goals, and
1e- guiding principles for reducing the health impact of STBBIs in Canada

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32
Q

what are the 4 pillars and 1 underlying foundation of the Pan Canadian STBBI Framework for Action (5)

A

1- prevention
2- testing
3- initiation of care and treatment
4- ongoing care and support
5- supportive environments

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33
Q

what are some reasons for emerging infectious diseases (3)

A

1- globalization and environment
2- sociodemographic factors
3- public health system failures

34
Q

re: reasons for emerging infectious diseases, what does ‘globalization and environment’ entail -
MTN GC
(5)

A

1- migration
2- travel/tourism
3- natural environment changes
4- global trade
5- climate changes

35
Q

re: reasons for emerging infectious diseases, what does ‘sociodemographic factors’ entail - VILOPT (6)

A

1- vulnerable (made to be) populations
2- inequities (in SDoH)
3- lifestyle behaviours
4- occupational factors
5- prevention measures
6- terrorism

36
Q

what is the agent for lyme disease (1)

A

1- Borrelia burgdorferi

37
Q

what is the reservoir for lyme disease (2)

A

1- mice
2- deer

38
Q

what is the mode of transmission for lyme (1)

A

1- tick-borne (Ixodes
scapularis [black legged/deer tick], pacificus, and angustus)

39
Q

what is the incubation period for lyme disease - range (1)

A

1- 3-32 days

40
Q

is there a communicable period for lyme (1)

A

1- NO, there is no person-to-person transmission/spread

41
Q

what are the 4 stages of clinical presentation for lyme (4)

A

1- early local
2- early disseminated
3- late
4- post-lyme disease syndrome

42
Q

what is the clinical presentation of early local lyme - FEM FHAM (7)

A

1- fever
2- erythema migrans (bulls eye rash)
3- myalgias
4- fatigue
5- headache
6- arthralgias
7- malaise

43
Q

what is the clinical presentation of early disseminated lyme - MC MAC (5)

A

1- multiple erythema migrans rashes
2- carditis
3- meningitis
4- arthralgias
5- cranial nerve palsies

44
Q

what is the clinical presentation of late lyme - EROC (4)

A

1- encephalopathy
2- recurrent arthritis
3- optic neuritis
4- carditis

45
Q

what is the clinical presentation of post-lyme disease syndrome - CSF (3)

A

1- cognitive impairment

46
Q

what is case management for lyme (1abcd)

A

1a- treat with doxycycline only if:
1b- tick was blacklegged
1c- tick was attached for <24h
1d- doxy is given within 72 hours of tick being removed

47
Q

is there contact management for lyme (1)

A

1- NO, not applicable

48
Q

what are things you can do to mitigate risk of acquiring lyme - LIAA (4)

A

1- long pants/shirts (wear)
2- insect repellant that has DEET or icaridin
3- avoid tick-infested areas
4- active surveillance is done in Canada via Canadian Lyme Sentinel Network (CaLSeN)

49
Q

what is the reservoir for west nile virus (WNV) (1)

A

1- birds

50
Q

what is the mode of transmission for WNV (2)

A

1- vector-borne (culex mosquitoes)
2- blood-borne (transfusion, organ transplantation)

51
Q

what is the incubation period for WNV - range (1)

A

1- 2-21 days

52
Q

what is the communicable period for WNV (1)

A

1- <7 days in immunocompetent persons

53
Q

what is the most common clinical presentation for WNV (1)

A

1- majority of cases are asymptomatic

54
Q

if there are symptoms, what is the clinical presentation for WNV - I-HMF (1)

A

1- mild influenza-like illness (ILI) - headache, myalgia, fever

55
Q

what are rare (<1% of cases) symptoms of WNV N-MEA (1)

A

1- neurological symptoms (meningitis, encephalitis, acute flaccid paralysis)

56
Q

what is case management for WNV (2)

A

1- supportive management
2- educate that case should not donate blood or organs

57
Q

what is contact management for WNV (1)

A

1- none - not applicable

58
Q

what can you do to mitigate risk of acquiring WNV - 4Ds (3)

A

1- DEET insect repellant when outdoors
2- Dress with long sleeve tops/pants
3- Drain standing water
4- Dusk to Dawn (limit time spent outdoors in these hours)

59
Q

what is the reservoir for zika virus (1)

A

1- likely humans

60
Q

what is the mode of transmission for zika - VBVS (4)

A

1- vector-borne (aedes aegypti)
2- blood-borne
3- vertical
4- sexual

61
Q

what is the incubation period for zika - average (1)

A

1- 3-14 days

62
Q

what is the communicable period for zika (1)

A

1- unclear

63
Q

what is the most common clinical presentation of zika (1)

A

1- 75% of cases are asymptomatic

64
Q

if there are symptoms, what is the clinical presentation of zika - MR GCFH (6)

A

1- myalgias
2- rash
3- GBS
4- conjunctivitis (purulent)
5- fever
6- headache

65
Q

what are features of congenital zika syndrome - H-COMA (5)

A

1- hypertonicity/seizures
2- club foot
3- ocular anomalies
4- microcephaly
5- abnormal brain development

66
Q

what is case management for zika (1)

A

1- supportive management, no treatment
2- serology recommended only for pregnant women who are symptomatic, have travel hx, or sexual partner with travel hx to zika-endemic region

67
Q

what is contact management for zika (1)

A

1- none, not applicable

68
Q

what can you do to mitigate risk of acquiring zika - personally, and as per CATMAT (2)

A

1- measures to prevent mosquito bites
2- CATMAT no longer recommends that pregnant travellers avoid zika-endemic regions or take special precautions to prevent sexual transmission while abroad or upon return

69
Q

what is the ddx for for GI symptoms that usually resolve within 24 hours - ABC-SENS (7)

A

1- Staph Aureus enterotoxin
2- Bacillus Cereus enterotoxin
3- Clostridium perfringens
4- Salmonella
5- E. Coli
6- Norovirus
7- Shigella

70
Q

**what is the ddx for GI illnesses that cause bloody diarrhea - “Your Shit Smells Extra Crappy” (5)

A

1- yersinia
2- shigella
3- salmonella
4- e. coli
5- campylobacter

71
Q

what is the agent for campylobacter enteritis (campy) (1)

A

1- campylobacter jejuni

72
Q

what is the reservoir for campy (3)

A

1- poultry
2- cattle
3- pets

73
Q

what is the mode of transmission for campy (2)

A

1- direct contact
2- ingestion (undercooked meat)

74
Q

what is the incubation period for campy - range (1)

A

1-
1-10 days

75
Q

what is the communicable period for campy (1)

A

1- it is shed in feces for days to weeks

76
Q

what is the clinical presentation of campy - NDA-FM (5)

A

1- nausea/vomiting
2- diarrhea, bloody or non
3- abdominal pain
4- fever
5- malaise

77
Q

what is case management for campy (1)

A

1- exclude food handlers, HCW, daycare staff/attendees until symptoms have resolved for 24h

78
Q

what is contact management for campy (2)

A

1- exclude symptomatic contacts
2- test asymptomatic contacts if outbreak

79
Q

what is the agent for cholera (1)

A

1- vibrio cholerae

80
Q

what is the reservoir for cholera (2)

A

1- humans
2- contaminated water

81
Q

what is the mode of transmission of cholera (2)

A

1- fecal-oral
2- ingestion (contaminated food/water/shellfish)

82
Q
A

2025 PHPM Royal College Study - based on AN Summary Notes (13 decks)

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